Chronic Myofascial Pain and Central Sensitization: Integrating Objective Findings with Pain Mechanisms, Dry Needling and Electrical Stimulation Techniques

This comprehensive two-day workshop will combine didactic presentations with practical hands-on assessment and treatment techniques. We will explore the dynamic and pivotal roles that myofascial trigger points (MTrPs), sensitization, limbic system dysfunction and objective physical findings play in the evaluation and management of chronic myofascial pain and dysfunction.

Course Description

By integrating the fascinating knowledge emerging from the pain sciences in a clinically accessible way, participants will apply important palpation skills with various needling techniques to help treat painful MTrPs and sensitized spinal segments more effectively. Spinal segmental sensitization (SSS) is a hyperactive state of the dorsal horn caused by bombardment of nociceptive impulses. Painful MTrPs are a very common source of persistent nociception and sensitization that often results in SSS and chronic myofascial pain. Conversely, maladaptive changes in subcortical structures and dysfunctional descending inhibition may create somatic tissue abnormalities (e.g., tissue texture changes, tenderness, etc.) in addition to adversely impacting mood, affect and sleep. Either way, typical manifestations of the sensitized spinal segment include dermatomal allodynia/hyperalgesia, sclerotomal tenderness and MTrPs within the affected myotomes. These objective and reproducible findings allow the clinician and patient to identify the affected spinal segment(s) that should be treated. Non-pharmacological approaches such as dry needling, electrical stimulation techniques and acupuncture will be discussed, demonstrated and practiced by attendees. These techniques deactivate painful MTrPs, desensitize affected segments and neuro-modulate subcortical dysfunction, providing more permanent pain and symptom relief. The diagnostic and treatment techniques presented in this seminar are applicable in the management of a variety of chronic musculoskeletal pain conditions.